6XZ-17805-21476
3 vaccinations
7 coded responses
25 check-ins
7 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 300 / GA
- Registered
- 2021-04-20
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-04-20
Registered in v-safe
-
2021-04-20
Dose 1 — Moderna
- 2021-04-20
- 2021-04-21
- 2021-04-23
- 2021-04-24
- 2021-04-25
- 2021-04-26
- 2021-04-27
- 2021-05-06
- 2021-05-11
- 2021-05-18
-
2021-05-19
Dose 2 — Moderna
- 2021-07-22
-
2022-01-11
Dose 3 — Moderna
-
2022-01-13
Survey response — days 1–6 daily, dose 3MedDRA: Oedema peripheral — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend schoolFree text: Swollen armpit (left side )MedDRA releases: 2024-11 · check-in free text available
-
2022-01-14
Survey response — days 1–6 daily, dose 3MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Swollen armpit (left side )MedDRA releases: 2024-11 · check-in free text available
-
2022-01-15
Survey response — days 1–6 daily, dose 3MedDRA: Oedema peripheral — Feeling: Good · Site: Pain, SwellingFree text: Swollen armpit (left side)MedDRA releases: 2024-11 · check-in free text available
-
2022-01-16
Survey response — days 1–6 daily, dose 3MedDRA: Oedema peripheral — Feeling: GoodFree text: I have a very little swollen armpit today ,very littleMedDRA releases: 2024-11 · check-in free text available
-
2022-01-17
Survey response — days 1–6 daily, dose 3MedDRA: Oedema peripheral — Feeling: GoodFree text: Armpit swollen is goneMedDRA releases: 2024-11 · check-in free text available
- 2022-01-18
- 2022-01-25
-
2022-02-01
Survey response — day 21, dose 3MedDRA: Bell's palsy, Eyelid function disorder, Facial paralysis — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, HospitalizationFree text: On 1/27 I wasn't able to close my left eye.On 1/28 I had half of my lips paralyzed on the left side .Half of my face left side .I was diagnosed with Bell's Palsy on 1/29 .I got my last booster on 1/11 .MedDRA releases: 2024-11 · check-in free text available
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2022-02-01
Report sent to call center — day 21, dose 3Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prEmergency room or emergency department visit · Hospitalization · 1 call case(s)
- 2022-02-02
-
2022-02-03
Call successfulCompleted over the phone
-
2022-02-08
Survey response — day 28, dose 3MedDRA: Bell's palsy, Lymphadenopathy — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Beside the Bell's palsy, I started with Swollen glands behind my ears ,both sides on 2/4MedDRA releases: 2024-11 · check-in free text available
- 2022-02-15
- 2022-02-22
- 2022-04-12
- 2022-07-12
- 2023-01-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-20 | Moderna | |
| 2 | 2021-05-19 | Moderna | No |
| 3 | 2022-01-11 | Moderna | No |
Call center
1 call center case
1 successful
VAERS report filed, before or during a call: 1
Free text
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Swollen armpit (left side )
Systemic reaction (other): Swollen armpit (left side )
Systemic reaction (other): Swollen armpit (left side)
Systemic reaction (other): I have a very little swollen armpit today ,very little
Systemic reaction (other): Armpit swollen is gone
Release 11 — day 21, dose 3
Symptoms: On 1/27 I wasn't able to close my left eye.On 1/28 I had half of my lips paralyzed on the left side .Half of my face left side .I was diagnosed with Bell's Palsy on 1/29 .I got my last booster on 1/11 .
Release 11 — day 28, dose 3
Symptoms: Beside the Bell's palsy, I started with Swollen glands behind my ears ,both sides on 2/4
Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".
MedDRA terms by release
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Bell's palsy | · | · | ✓ |
| SD | Eyelid function disorder | · | · | ✓ |
| SD | Facial paralysis | · | · | ✓ |
| SD | Lymphadenopathy | · | · | ✓ |
| SRO | Oedema peripheral | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release